Concierge endocrinology · UK
Private hyperthyroidism treatment, by a consultant endocrinologist.
A proper diagnosis — Graves’, toxic nodular or thyroiditis — and all three definitive treatment options on the table: antithyroid drugs, radioactive iodine or thyroidectomy. Chosen honestly, with your life in mind.
Why patients choose us
- 01
A consultant endocrinologist, not a generalist
A named endocrinologist who treats thyroid disease weekly — with proper access to TRAb testing, uptake scans and MDT input.
- 02
All three definitive options on the table
Antithyroid drugs, radioactive iodine or thyroidectomy — the choice is yours, informed rather than defaulted.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private hyperthyroidism care costs in the UK.
Indicative ranges across our partner clinics. Radioactive iodine remains free on the NHS; carbimazole is a few pounds a month. We quote firm figures for the private route within one working day.
In short
Consultant endocrinology in our network: £250–£450 initial, £150–£250 reviews.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial endocrinology consultation | £250–£450 | 45–60 min | Same visit |
| Follow-up review | £150–£250 | 20–30 min | Same visit |
| TFTs + TPO-Ab + TRAb bloods | £120–£220 | 10 min draw | 2–5 days |
| Thyroid ultrasound | £220–£400 | 20 min | Same visit |
| Radionuclide uptake scan (Tc-99m) | £450–£750 | Half-day | 1–3 days |
| Radioactive iodine (I-131) therapy | NHS free · £1,800–£3,500 private | Half-day | 6–12 months to effect |
| Total thyroidectomy (private) | £8,500–£14,000 | Overnight stay | 2–4 weeks recovery |
| Carbimazole (prescription) | £5–£15 / month | Daily tablet | 4–8 weeks to euthyroid |
Prices vary by clinic, by which endocrinologist takes the case, and by which definitive treatment is chosen. Radioactive iodine is free on the NHS. We come back with a firm quote within one working day.
The problem
The right diagnosis, the right option, the right endocrinologist.
Hyperthyroidism is often diagnosed but poorly explained. Which cause? Which treatment? What about the eyes, pregnancy, side effects? We fix the whole picture, not just the TSH.
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Not sure of the cause?
Graves’, toxic nodular or thyroiditis — the treatment differs completely. We finish the diagnosis before we treat.
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Weighing your options?
Antithyroid drugs, radioactive iodine or surgery — with pregnancy plans and eye disease considered.
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Worried about eye disease?
Thyroid eye disease needs joint care. If you smoke, or if the eyes are already active, that changes the plan.
The journey
From enquiry to long-term monitoring — what happens, in order.
One endocrinologist from first message to yearly review — through diagnosis, treatment and beyond.
Phase 1 · Before treatment
Concierge, off-stage for you
Phase 2 · Consultation day
Diagnosis and plan agreed
Phase 3 · After
Long-term monitoring
- 01
Before
You tell us your symptoms and results
A short, confidential form. Palpitations, weight loss, tremor, eye changes — plus any TFTs already done.
- 02
Before
We come back with a recommendation
Within one working day: the right endocrinologist, likely tests (TRAb, US, uptake scan), and an indicative cost.
- 03
Before
We arrange the consultation
Usually within one to two weeks. Bloods, ultrasound and any uptake scan sequenced so nothing is repeated.
- 04
Consultation day
Consultation and diagnosis
Full history, examination and a plan — Graves’, toxic nodular, toxicosis from thyroiditis — with the treatment options for each.
- 05
Consultation day
Symptom control started the same day
A beta-blocker (usually propranolol) started immediately for tremor, palpitations and anxiety while the definitive plan begins.
- 06
Consultation day
Definitive treatment chosen
Carbimazole, radioactive iodine or surgery — explained honestly, with pregnancy, eye disease and lifestyle taken into account.
- 07
After
Monitoring and long-term follow-up
TFTs every 4–6 weeks initially, then quarterly. Levothyroxine started if you become hypothyroid. Yearly review long-term.
Typical time to euthyroid on carbimazole: 4–8 weeks. Radioiodine full effect: 6–12 months.
When it helps
When hyperthyroidism treatment is the right step.
The presentations we see most, plus the one red flag that means an emergency rather than a clinic booking.
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Graves’ disease
Autoimmune, TRAb positive in ~90%, diffuse uptake on scan — the commonest cause under 50.
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Toxic multinodular goitre
Multiple autonomous nodules, more common over 50 — usually needs radioiodine or surgery, not long-term drugs.
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Toxic adenoma
A single hot nodule producing thyroid hormone independently — often best treated with radioiodine or hemithyroidectomy.
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Thyroiditis (transient)
Subacute, post-partum or silent — low uptake on scan, self-limiting; treat symptoms with beta-blocker only.
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Thyroid eye disease (TAO)
Grittiness, bulging, double vision — needs joint endocrine and ophthalmology care; smoking makes it 8× worse.
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Hyperthyroidism in pregnancy
PTU in the first trimester, careful monitoring, and paediatric input — carbimazole is teratogenic early on.
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Relapse after antithyroid drugs
Around half of Graves’ patients relapse after a first course — radioiodine or surgery is usually the next step.
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Red flag: thyroid storm
Fever, tachycardia, agitation, vomiting or confusion in an untreated patient is a medical emergency — 999 or A&E.
Treatment options
Antithyroid drugs, radioiodine or surgery — the three real options.
What each option actually involves — and which fits which underlying cause and life circumstance.
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Beta-blocker (symptom control)
Propranolol 20–40mg four times daily controls tremor, palpitations and anxiety while the definitive plan takes effect.
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Carbimazole (first-line UK)
Titration or block-and-replace. Typical start 20–40mg daily, tapered by TFTs. 12–18 months for Graves’; ~30–50% remit.
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Propylthiouracil (PTU)
Used in the first trimester of pregnancy, in thyroid storm, or where carbimazole is not tolerated. Rare hepatotoxicity risk.
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Radioactive iodine (I-131)
A single oral capsule via nuclear medicine day unit — 400–600 MBq. 80–90% become euthyroid or hypothyroid at 6–12 months.
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Total thyroidectomy (Graves’)
BAETS-accredited surgeon; euthyroid pre-op; Lugol’s iodine 10 days before. Lifelong levothyroxine afterwards.
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Hemithyroidectomy (toxic nodule)
Removes the offending lobe with the hot nodule — often preserves normal thyroid function without needing replacement.
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TAO care alongside treatment
Selenium (mild), IV methylprednisolone pulses (moderate–severe), teprotumumab or decompression for sight-threatening disease.
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Thyroid storm (emergency)
ITU-level care: beta-blocker, PTU, hydrocortisone, cooling and iodine. Mortality remains 10–30% despite modern care.
Our vetted UK network
A small panel of endocrinologists, we picked them.
Consultant endocrinologists and BAETS-accredited surgeons across the UK. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every endocrinologist in our network.
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Consultant endocrinologists on the GMC Specialist Register, thyroid-focused practice
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BAETS-accredited endocrine surgeons for thyroidectomy referrals
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Nuclear medicine partners for radioiodine with proper radiation-safety counselling
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Joint ophthalmology input for thyroid eye disease when needed
Safety and monitoring
What to expect from treatment — honestly.
Every option has trade-offs. The things worth planning are the drug side-effect safety-net, the radiation rules if you choose radioiodine, and the small surgical risks if you go for thyroidectomy.
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Carbimazole side effects to know
Rash in ~5%. Agranulocytosis is rare (0.2–0.5%) but serious — any sore throat, mouth ulcer or fever means an urgent FBC and stopping the drug.
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Hepatotoxicity is rare but real
Both carbimazole and PTU can, uncommonly, cause liver injury — LFTs are checked at baseline and if you develop jaundice, dark urine or right-upper-quadrant pain.
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Pregnancy planning matters
Carbimazole is teratogenic in the first trimester (aplasia cutis, choanal atresia). PTU is preferred until 16 weeks; radioiodine is absolutely contraindicated.
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Radioiodine radiation-safety rules
For about two weeks: stay >2m from adults for hours a day, separate bed from children and pregnant partners for 1–2 weeks, and use your own toilet.
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Radioiodine and the eyes
Radioiodine can worsen thyroid eye disease in around 15% — steroid cover is offered if you smoke or have active TAO; sometimes surgery is chosen instead.
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Surgical complications to weigh
Transient low calcium in 20–30%; permanent hypoparathyroidism 1–3%; voice-nerve injury transient 3–5%, permanent under 1%; bleeding needing return to theatre ~1%.
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Lifelong levothyroxine is common
After radioiodine or total thyroidectomy most people need daily levothyroxine — a once-a-day tablet, monitored by TFTs, that fully replaces the missing hormone.
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Smoking cessation is critical
Smoking increases the risk of thyroid eye disease progression eightfold — stopping is the single most effective thing you can do for your eyes.
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Red flags: thyroid storm
Fever, racing pulse, agitation, vomiting, confusion or heart failure in someone with untreated hyperthyroidism is a 999 emergency — mortality 10–30%.
Reading your clinic letter
Your clinic letter in four parts. Read the last one first.
Whichever treatment is recommended, the endocrinologist’s letter keeps to the same shape.
A quiet reminder
Endocrine language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the letter before your review, just ask.
- 01 Diagnosis
TFTs, antibodies and imaging
TSH suppressed with raised free T4/T3, TRAb (positive in ~90% of Graves’), TPO-Ab, and ultrasound or uptake scan findings.
- 02 Cause
Graves’, toxic nodular or thyroiditis
The underlying diagnosis drives everything — diffuse uptake (Graves’), focal hot nodule (toxic adenoma) or low uptake (thyroiditis, self-limiting).
- 03 Plan
Treatment recommended and why
Which of the three definitive options is recommended for you, why, and what the alternatives would look like.
- 04 Impression
Monitoring, follow-up and safety-net
Read this first: what TFTs are due when, sore-throat safety-net for carbimazole, and when to phone in urgently.
Recognised by major UK insurers
Endocrinology consultations, thyroid imaging and thyroidectomy are usually covered by major UK insurers when medically indicated. We confirm cover before booking.
Frequently asked
Everything we get asked about hyperthyroidism.
Quick answers on diagnosis, drug side effects, radioiodine, surgery, pregnancy and thyroid eye disease.
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What causes hyperthyroidism?
The three commonest causes are Graves’ disease (autoimmune, TRAb positive), toxic multinodular goitre and a solitary toxic adenoma. Thyroiditis — subacute, post-partum or silent — also causes a transient hyperthyroid phase that settles by itself.
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How is hyperthyroidism diagnosed?
A suppressed TSH with raised free T4 and/or T3 makes the biochemical diagnosis. TRAb antibodies, thyroid ultrasound and, where the picture is unclear, a radionuclide uptake scan tell us the cause — which decides the treatment.
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What are the treatment options in the UK?
Three definitive options: antithyroid drugs (carbimazole first-line, PTU in pregnancy), radioactive iodine (I-131), or thyroid surgery. Alongside these a beta-blocker like propranolol controls tremor, palpitations and anxiety within days.
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How does carbimazole work and what are the side effects?
Carbimazole blocks thyroid hormone production. It works within 4–8 weeks. Rash affects around 5%. Agranulocytosis (0.2–0.5%) is the serious warning — any sore throat, mouth ulcer or fever means stop the drug and get an urgent FBC. LFT problems are rare.
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What does radioactive iodine involve?
A single oral capsule (400–600 MBq) at a nuclear medicine day unit. You go home the same day but follow radiation-safety rules for about two weeks — distancing from children, pregnant partners and other adults. Around 80–90% become euthyroid or hypothyroid within 6–12 months; most eventually need levothyroxine.
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When is thyroid surgery the right choice?
Total thyroidectomy is preferred for a large goitre with compressive symptoms, severe or active thyroid eye disease where radioiodine is unsafe, imminent pregnancy planning, suspected cancer, failed drug and radioiodine therapy, or patient preference. It is done by a BAETS-accredited endocrine surgeon.
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What about hyperthyroidism in pregnancy?
Propylthiouracil (PTU) is used in the first trimester because carbimazole can cause rare but serious birth defects (aplasia cutis, choanal atresia). After 16 weeks the picture shifts. Radioiodine is absolutely contraindicated in pregnancy and while breastfeeding.
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What is thyroid eye disease and how is it treated?
Around a quarter of people with Graves’ develop eye changes — grittiness, bulging, double vision. Mild disease is watched with selenium; moderate to severe needs IV methylprednisolone; teprotumumab and orbital decompression are for the most severe cases. Stopping smoking is the single most important thing you can do.
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How much does private hyperthyroidism care cost in the UK?
An initial endocrinology consultation is typically £250–£450, follow-ups £150–£250, TFTs plus antibodies £120–£220, thyroid ultrasound £220–£400. Carbimazole itself is £5–£15 a month. Private radioiodine is £1,800–£3,500; a private total thyroidectomy is £8,500–£14,000.
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When should I go to A&E?
Fever with a sore throat or mouth ulcers while on carbimazole (possible agranulocytosis). Fever, racing pulse, agitation, vomiting or confusion in someone with untreated hyperthyroidism (possible thyroid storm, mortality 10–30%). Sudden loss of vision or severe eye pain with thyroid eye disease. All are same-day emergencies.